Rheumatoid arthritis (RA) is a chronic, disabling disease that can compromise daily functioning, and health related quality of life (HRQOL), especially for young populations for whom long-term medication use can pose risks. This R21 project will compare a standardized group administered Iyengar Yoga program (IYP) for adolescents and young adults (AYA) with RA to a waitlist control condition comprised of standard care. IY is particularly suitable for clinical rehabilitation and research, as extensive and standardized teacher-training makes it replicable and safe. Our hypotheses are: 1) The IYP will be safe, acceptable and feasible for a young RA population, with <20% attrition;2) IYP participants will demonstrate significantly greater improvement on the primary outcomes of functioning and HRQOL relative to the control group following the 8 week IYP;treatment gains will be maintained at 2 months following completion of the IYP;3) IYP participants will also evidence significant improvement relative to controls on the secondary outcomes of pain, joint count, and mood. This project is built within a theoretical model purporting that Iyengar Yoga incorporates specific psychological and physical components that confer benefits on RA disability and HRQOL. Using a matched group design, 84 RA patients aged 16-21 years will receive an 8 week IYP (16 - 1.5 hour sessions twice weekly) or be assigned to the 8 week control condition, after which they will receive the 8 week IYP. Baseline, post-treatment, and two month follow-up assessments include standardized measures of general and arthritis-specific function, HRQOL, pain, mood, and inflamed joint count as well as qualitative interviews, and blood pressure/resting heart rate measurements. This study will be the first controlled evaluation of IYP for an AYA RA population and the study is grounded within a theoretical model that integrates the biopsychosocial model of rehabilitation. To maximize the knowledge gained from the study, we employ a quantitative/qualitative mixed methods approach to understanding treatment outcomes and predictors of treatment response. Ultimately our study will contribute to the development of a readily transportable IYP that may be used in multi-center trials and disseminated widely to other research and clinical settings, thus providing heuristic and practical value. Relevance: Conventional treatments for AYA with RA pose risks because of the need for long-term intervention. This study addresses the need for safe and effective rehabilitation approaches to RA by testing a standardized IY program within a rigorously conducted, theoretically-driven design to promote the science behind a treatment that could positively impact the lives of many young people with a disabling disease. PUBLIC HEALTH RELEVANCE: Conventional treatments for AYA with RA pose risks because of the need for long-term intervention. This project addresses the need for safe and effective rehabilitative approaches to RA by testing a standardized Iyengar Yoga program within a rigorously conducted, theoretically based study in order to provide the science behind a treatment that could positively impact the lives of many young people with disabling arthritis.